HEALTH PLAN NOTICES Special Enrollment Rights - If you are declining enrollment for yourself or your same deductibles and co-insurance applicable to other medical and surgical dependents (including your spouse) because of other health insurance or benefits provided under the ABC Company Health Plan. If you would like more group health plan coverage, you may be able to enroll yourself and your information on WHCRA benefits, please call your Plan Administrator dependents in this plan if you or your dependents lose eligibility for that other Regarding Lifetime and Annual Dollar Limits - In accordance with coverage(or if the employer stops contributing toward your or your Notice dependents’ other coverage). However, you must request enrollment within 30 applicable law, any lifetime dollar limits and annual dollar limits set forth in the days after your or your dependents’ other coverage ends (or after the employer Plan shall not apply to “essential health benefits,” as such term is defined under stops contributing toward the other coverage). In addition, if you have a new Section 1302(b) of the Affordable Care Act. The law defines “essential health dependent as a result of marriage, birth, adoption, or placement for adoption, benefits” to include, at minimum, items and services covered within certain you may be able to enroll yourself and your dependents. However, you must categories including emergency services, hospitalization, prescription drugs, request enrollment within 30 days after the marriage, birth, adoption, or rehabilitative and habilitative services and devices, and laboratory services. A placement for adoption. To request special enrollment or obtain more determination as to whether a benefit constitutes an “essential health benefit” information, contact the Plan Administrator. will be based on a good faith interpretation by the Plan Administrator of the Grandfathered Status - The Plan believes that none of the group health plans guidance available as of the date on which the determination is made. available under the Plan are “grandfathered health plans” as described under Patient Protection Disclosure - You have the right to designate any the Patient Protection and Affordable Care Act (the “Affordable Care Act”). participating primary care provider who is available to accept you or your Special Rule family members (for children, you may designate a pediatrician as the primary for Maternity and Infant Coverage - Group health plans and care provider). For information on how to select a primary care provider and for health insurance issuers generally may not, under Federal law, restrict a list of participating primary care providers, contact the Plan Administrator. benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, You do not need prior authorization from the Plan or from any other person, or less than 96 hours following a cesarean section. However, Federal law including your primary care provider, in order to obtain access to obstetrical or generally does not prohibit the attending provider or physician, after gynecological care from a health care professional; however, you may be consulting with the mother, from discharging the mother or her newborn required to comply with certain procedures, including obtaining prior earlier than 48 hours (or 96 hours, as applicable). authorization for certain services, following a pre-approved treatment plan, or Special Rule procedures for making referrals. For a list of participating health care for Women’s Health Coverage (WHCRA) - If you have had or are professionals who specialize in obstetrics or gynecology, contact the health going to have a mastectomy, you may be entitled to certain benefits under the plan. Women's Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner - Michelle’s Law provides continued health and dental determined in consultation with the attending physician and the patient, for: Michelle’s Law all stages of reconstruction of the breast on which the mastectomy was insurance benefits under the Plan for dependent children who are covered performed; surgery and reconstruction of the other breast to produce a under the Plan as a student but lose their student status in a post-secondary symmetrical appearance; prostheses; and treatment of physical complications school or college because they take a medically necessary leave of absence of the mastectomy, including lymphedema. These benefits will be provided from school. If your child is no longer a student because he or she is out of subject to the school because of a medically necessary leave of absence, your child may continue to be covered under the Plan for up to one year from the beginning of the leave of absence.